In post-Brexit Britain, the coronavirus crisis comes amid a crisis of confidence in its political leadership. The British public is now watching the National Health Service (NHS) trying to rise to the challenge after a decade of austerity. To make things worse, Boris Johnson’s initial misguided policy of ‘herd immunity’ left the public confused and uncertain about the government’s approach. The coronavirus outbreak hits the UK at a weak spot, its neglected health service. More than during the Brexit debate, this crisis is raising questions about where post-Brexit Britain is going. With Boris Johnson having been hospitalised for coronavirus, the political leadership seems even more precarious.
Firstly, there was the debacle of the so-called ‘herd immunity’ argument. Boris Johnson and the Chief Medical Officer downplayed the predicted death toll, arguing that drastic social distancing would not be necessary. But as the possible death rate for the UK emerged, this approach looked at best defeatist and at worst cynical. The government has since changed its strategy and come more into line with the mainstream approach of strict social distancing measures.
The initial policy was a classic case of ‘group think’: the result of politicians surrounding themselves by too many advisors who agree with or at least do not challenge each other. A consequence of the divisive campaigning of the recent Brexit years. Crucially, in this case, they forwent medical and clinical input, instead surrounding themselves with mathematicians and behavioural scientists.
Then came the testing controversy. British health secretary Matt Hancock has admitted that the UK has a long way to go to catch up with other European countries. But this admission comes after weeks of defending a low testing policy which was initially linked to the above-mentioned ‘herd immunity’ approach. Low testing contradicts WHO advice and leaves NHS workers across the country untested. Additionally, the government appears to have made false promises on the availability of home testing kits and the feasibility of immunity testing.
Finally, there is a lack of protective equipment for NHS workers. Medical experts had called for stockpiling of the equipment when coronavirus became a crisis in China, warning that it would spread to Europe. But this advice was ignored.
The British government hoped to lead with its economic response and generate confidence this way. Its fiscal response of over 15% of GDP is in a similar ballpark as the German response. But the very different approval rates of governments in Germany (93%) and the UK (from 36% during herd immunity to the current policy at 52%) show that confidence cannot be won simply on economic grounds.
The sacred but neglected NHS
For many in Britain, the NHS is the symbol of British welfare and solidarity. It is a great source of national pride. It is hard to understand, let alone explain, the emotional attachment of the Brits to ‘their’ NHS. Readers may remember that the London 2012 Olympic Games opening ceremony included a sequence on the NHS with dancing nurses. While it baffled the rest of the world, it moved the country to tears. This nostalgia is tainted by the everyday experience of NHS staff and patients. Severe staffing issues and underfunding have led to alarmingly deteriorating patient care in recent years.
The NHS was the battleground topic over Brexit and the election in December. Promises of greater funding for the NHS became an easy populist promise for the Leave camp during the Brexit referendum. The Remain campaign stressed the need for international staff to be able to come to the UK, pointing out that 10% of NHS staff alone are EU nationals. The past five years of political debate and promises about the issue did little to support the stricken health service.
Hospital beds are being occupied by elderly patients who cannot go home due to a lack of social care. The NHS exists in a welfare vacuum. The recent change to a points-based immigration system is likely to complicate staffing issues. Furthermore, despite the promises, the UK budgets after the referendum did not provide the necessary relief for the NHS from the austerity measures.
The stark difference between the NHS in the collective imagination and the daily reality for health workers is now laid bare: one of the richest countries on the planet with a world-renowned scientific and medical community has fallen behind in its response to coronavirus with health care workers worrying about their safety.
Johnson still running in Brexit mode
The misplaced health strategy was amplified by a misguided attempt to frame the UK’s response in the Brexit context. Rather than taking advantage of the transition period and the EU coordination that is taking place, the UK has gone out of its way to avoid European cooperation. It opted out of the joint phone calls with EU health ministers, thereby missing out on the deadline for joint procurement of desperately needed protective equipment. The initial claim that the UK was going to go ‘its own way’ rather than admitting the mistake was met with disbelief.
Many have pointed to the fact that Brexit did after all prepare the UK for this crisis. Thanks to the stockpiling in preparation for a no-deal Brexit, food and medical stocks were higher than usual. However, these are already starting to run low. Because of damage to these stockpiles and the economy after this crisis, it is difficult to imagine how Britain is going to make it through the difficult first years of Brexit after the transition period ends in December, deal or no deal.
The need for a new social contract
For the past two years, the UK has been in a constant anxious state anticipating, yet not preparing for, a crisis. The Brexit debates around future trade deals, migration and the future of the NHS seem like theoretical exercises compared to the very real crisis the country is facing.
Coronavirus is forcing the UK to look at fundamental weaknesses in its health and social care. The question of what this country wants to be and whether it lives up to its expectations, not least with the NHS, is a very real one for people around the country. We can also see a new and persistent media scrutiny of the government’s policy, which, it could be argued, was lacking during the Brexit debate. Political partisanship is also diminishing as critiques of the government’s policy came from all political parties and across the Brexit divide.
Like for any country, it is unthinkable to imagine the UK coming out of this experience unchanged. Even Boris Johnson said recently, contradicting Margaret Thatcher’s famous quote, that ‘there is such a thing as society’. But after the peak of this crisis, Britain will be facing the prospect of potentially running into another crisis with an ill-prepared Brexit. It may leave little time for the introspective review so desperately needed. Britain needs time to recover, rebuild and re-imagine.
Dr Julia Himmrich is a researcher, policy adviser, and former Dahrendorf Postdoctoral Fellow at the London School of Economics.
This article was originally published by the Heinrich Böll Stiftung.